The Duluth CCOP, established and funded by the National Cancer Institute (NCI) in 1984 and refunded in 1987, 1990, 1995, and 2000, is the only program of its kind in northern Minnesota and Northern Wisconsin. The Duluth CCOP is comprised of physicians and ancillary support staff who practice under the umbrella of the St. Mary's Duluth Clinic Health System (SMDC) in three institutions in Duluth, MN: the Duluth Clinic Cancer Center (DCCC), St. Mary's Medical Center, and Miller Dwan Medical Center. Hematology/Oncology clinics are also served by DCCC hematologists/oncologists at various regional outreach sites throughout the catchment area. Geographically, the Duluth CCOP covers a large area including urban and rural areas. The CCOP brings the benefits of clinical research to patients in a region that would be without access to clinical trials due to the distance to the nearest comprehensive cancer center. The strategy of the CCOP is to provide patients in the region access to state-of-the-art cancer care through participation in treatment and cancer control protocols and increase accrual to cancer prevention and control protocols. NCCTG will continue to function as the primary research base of the CCOP and secondary research bases will be Eastern Cooperative Oncology Group, National Surgical Breast and Bowel Program, Children's Oncology Group, American College of Surgeons Oncology Group, and the Comprehensive Cancer Center of Wake Forest University CCOP research base. The goal of the CCOP is accrue 200 patient credits to treatment protocols and 310 patient credits to prevention/cancer control protocols per year. By virtue of the already established programs and the commitment to quality, it is believed that a high level of productivity and quality can be maintained.